If you want to stop smoking, taking bupropion (trade name Zyban®) roughly doubles your chance of success.
Nicotine is a drug that is inhaled from the tobacco in cigarettes. It gets into the bloodstream, and stimulates the brain. Most regular smokers are addicted to nicotine.
If you are a smoker, when the blood level of nicotine falls, you usually develop withdrawal symptoms such as restlessness, increased appetite, inability to concentrate, irritability, dizziness, constipation, nicotine craving, or just feeling awful. These symptoms begin within a few hours after having the last cigarette. If they are not relieved by the next cigarette, withdrawal symptoms get worse. If you do not smoke any more cigarettes, the withdrawal symptoms peak after about 24 hours, and then gradually ease over about 2-4 weeks. So, most smokers smoke regularly to feel 'normal', and to prevent withdrawal symptoms.
About 2 in 3 smokers want to stop smoking but, without help, many fail to succeed. The main reason why so few smokers succeed, even though they want to stop smoking, is because nicotine addiction is strong and difficult to break. This is where bupropion can help.
Doctors and patients can use Decision Aids together to help choose the best course of action to take.
Compare the options for Bupropion (Zyban?).Bupropion is a medicine that was first developed to treat depression. It was found that it helped smokers to stop smoking. It is not clear how it works. It alters the level of some chemicals in the brain (neurotransmitters). This seems to relieve the withdrawal symptoms that you get when you stop smoking (such as craving, anxiety, restlessness, headaches, irritability, hunger, difficulty with concentration, or just feeling awful).
Taking bupropion does increase the chance of quitting smoking. Various studies have looked at this issue. The studies compared bupropion to a similar dummy (placebo) tablet in people who were keen to stop smoking. The results from the studies showed that, on average, about 19 in 100 people who took bupropion stopped smoking successfully. This compared to about 10 in 100 who took the dummy (placebo) tablet. In other words, about twice the number of smokers who take bupropion stop smoking compared to those who don't, and about 1 in 5 smokers who want to stop will do it with the help of bupropion.
Bupropion does not 'make' you stop smoking. You still need determination to succeed, and to break the smoking habit. A combination of bupropion with counselling from a nurse, doctor, pharmacist, or other health professional increases your chance of successfully stopping smoking. Therefore, most doctors will only prescribe bupropion to people who really want to stop smoking as part of a 'stopping smoking' programme.
Most people take bupropion without any problem. Read the packet leaflet for a full list of possible side-effects and cautions. The most common are: a dry mouth (which occurs in about 1 in 10 users) and some difficulty in sleeping (which occurs in about 1 in 3 users). Less common, but more serious possible side-effects include the following:
If this occurs you should not drive or operate machinery.
This occurs in about 1 in 1,000 people who take bupropion. Therefore, although this is uncommon, it can be serious, particularly if it occurs when you are operating machinery or driving. The risk of a seizure is increased if you have a history of certain medical conditions, or if you take certain medicines (listed below). Therefore, bupropion is not suitable for all people who wish to stop smoking (see below).
Blood pressure sometimes goes up in people who take bupropion. You should have a baseline blood pressure reading done before you start treatment and it should be monitored from time to time.
If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at the following web address: www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines may have caused. If you wish to report a side-effect, you will need to provide basic information about:
It is helpful if you have your medication - and/or the leaflet that came with it - with you while you fill out the report.
You should not take bupropion if you:
Also, the dose may need to be reduced if you have some medical conditions, or if you take certain medicines. Tell your doctor or pharmacist if you:
Bupropion combined with certain other medicines can increase the risk of having a seizure. Therefore, whilst you are taking bupropion, tell your doctor or pharmacist if you are prescribed or buy any new medicine. Also, tell a doctor or pharmacist if you are taking any of the following medicines:
Quit - a charity that helps people to stop smoking
Quitline: 0800 00 22 00 Web: www.quit.org.uk
Smokefree - information from the NHS
Free smoking helpline 0800 022 4 332 Web: www.smokefree.nhs.uk
For help and advice on stopping smoking, and for details of your local NHS Stop Smoking Service.